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Fee-for-service (FFS) is a payment model where services are unbundled and paid for separately. [ 1 ] In health care, it gives an incentive for physicians to provide more treatments because payment is dependent on the quantity of care, rather than quality of care.
In United States healthcare, service excellence is the ability of the provider to consistently meet and manage patient expectations. Clinical excellence must be the priority for any health care system. [1] However, the best healthcare systems combine professional (clinical) service excellence with outstanding personal service.
The Andersen healthcare utilization model is a conceptual model aimed at demonstrating the factors that lead to the use of health services. According to the model, the usage of health services (including inpatient care, physician visits, dental care etc.) is determined by three dynamics: predisposing factors, enabling factors, and need.
The concept of the Iron Triangle of Health Care was first introduced in William Kissick’s book, Medicine’s Dilemmas: Infinite Needs Versus Finite Resources in 1994, describing three competing health care issues: access, quality, and cost containment. [1] [2] Each of the vertices represents identical priorities. Increasing or decreasing one ...
Health Level Seven, abbreviated to HL7, is a range of global standards for the transfer of clinical and administrative health data between applications with the aim to improve patient outcomes and health system performance. The HL7 standards focus on the application layer, which is "layer 7" in the Open Systems Interconnection model.
The Donabedian model is a conceptual model that provides a framework for examining health services and evaluating quality of health care. [1] According to the model, information about quality of care can be drawn from three categories: "structure", "process", and "outcomes". [ 2 ]
All-payer rate setting is a price setting mechanism in which all third parties pay the same price for services at a given hospital. [1] It can be used to increase the market power of payers (such as private and/or public insurance companies) versus providers, such as hospital systems, in order to control costs.
Integrated care may be seen as a response to the fragmented delivery of health and social services being an acknowledged problem in many health systems. [1] [2] [3] This model of care is working towards moving away from a siloed and referral-based format of care to a team-based model.